Effect of the Duration of Deep Hypothermic Circulatory Arrest on the Neurodevelopmental Outcomes in Children Undergoing Cardiac Surgery

<b>Background/Objectives:</b> Deep hypothermic circulatory arrest (DHCA) is safe, but subtle neurodevelopmental deficits may persist far beyond the perioperative period. We aimed to investigate the relationship between DHCA duration and neurodevelopmental outcomes in young children under...

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Main Authors: Abdullah H. Ghunaim, Basma Aljabri, Ahmed Dohain, Ghassan S. Althinayyan, Abdulaziz I. Aleissa, Ahmad T. Alshebly, Rayan A. Alyafi, Tareg M. Alhablany, Ahmed M. Nashar, Osman O. Al-Radi
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Language:English
Published: MDPI AG 2024-08-01
Series:Pediatric Reports
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Online Access:https://www.mdpi.com/2036-7503/16/3/63
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author Abdullah H. Ghunaim
Basma Aljabri
Ahmed Dohain
Ghassan S. Althinayyan
Abdulaziz I. Aleissa
Ahmad T. Alshebly
Rayan A. Alyafi
Tareg M. Alhablany
Ahmed M. Nashar
Osman O. Al-Radi
author_facet Abdullah H. Ghunaim
Basma Aljabri
Ahmed Dohain
Ghassan S. Althinayyan
Abdulaziz I. Aleissa
Ahmad T. Alshebly
Rayan A. Alyafi
Tareg M. Alhablany
Ahmed M. Nashar
Osman O. Al-Radi
author_sort Abdullah H. Ghunaim
collection DOAJ
description <b>Background/Objectives:</b> Deep hypothermic circulatory arrest (DHCA) is safe, but subtle neurodevelopmental deficits may persist far beyond the perioperative period. We aimed to investigate the relationship between DHCA duration and neurodevelopmental outcomes in young children undergoing cardiac surgery with DHCA. <b>Methods:</b> Children aged < 42 months, including neonates who underwent cardiac surgery using DHCA without regional perfusion techniques, were included as the DHCA group. Children in the same age range who underwent cardiac surgery without DHCA were included as the control group. All enrolled patients underwent neurodevelopmental assessment using the Bayley Scales of Infant and Toddler Development (BSTID) by a trained pediatrician, and 17 DHCA patients and 6 control patients completed the BSTID assessment. <b>Results:</b> Both groups showed no significant preoperative, operative, or postoperative differences. Adjusted multivariable analysis revealed that prematurity and age at assessment were significant changing predictors of each of the BSTID components (<i>p</i> < 0.001), except for the gross motor component, where only age at assessment was a significant adjusting predictor. Longer DHCA was associated with lower fine and gross motor BSTID components; however, the association was not statistically significant (<i>p</i> = 0.06). <b>Conclusions:</b> Long-duration DHCA without regional perfusion techniques may be associated with less optimal neurodevelopmental outcomes.
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spelling doaj-art-cf5e73e1f4ec46bea1b0e7875b0b3fc32025-08-20T01:55:45ZengMDPI AGPediatric Reports2036-75032024-08-0116375376210.3390/pediatric16030063Effect of the Duration of Deep Hypothermic Circulatory Arrest on the Neurodevelopmental Outcomes in Children Undergoing Cardiac SurgeryAbdullah H. Ghunaim0Basma Aljabri1Ahmed Dohain2Ghassan S. Althinayyan3Abdulaziz I. Aleissa4Ahmad T. Alshebly5Rayan A. Alyafi6Tareg M. Alhablany7Ahmed M. Nashar8Osman O. Al-Radi9Cardiac Surgery Division, Department of Surgery, King Abdulaziz University, Jeddah 21589, Saudi ArabiaDepartment of Pediatrics, King Abdulaziz University, Jeddah 21589, Saudi ArabiaPediatric Cardiology Division, Department of Pediatrics, Cairo University, Cairo 12613, EgyptFaculty of Medicine, King Abdulaziz University, Jeddah 21589, Saudi ArabiaFaculty of Medicine, King Abdulaziz University, Jeddah 21589, Saudi ArabiaFaculty of Medicine, King Abdulaziz University, Jeddah 21589, Saudi ArabiaFaculty of Medicine, King Abdulaziz University, Jeddah 21589, Saudi ArabiaFaculty of Medicine, King Abdulaziz University, Jeddah 21589, Saudi ArabiaFaculty of Medicine, King Abdulaziz University, Jeddah 21589, Saudi ArabiaCardiac Surgery Division, Department of Surgery, King Abdulaziz University, Jeddah 21589, Saudi Arabia<b>Background/Objectives:</b> Deep hypothermic circulatory arrest (DHCA) is safe, but subtle neurodevelopmental deficits may persist far beyond the perioperative period. We aimed to investigate the relationship between DHCA duration and neurodevelopmental outcomes in young children undergoing cardiac surgery with DHCA. <b>Methods:</b> Children aged < 42 months, including neonates who underwent cardiac surgery using DHCA without regional perfusion techniques, were included as the DHCA group. Children in the same age range who underwent cardiac surgery without DHCA were included as the control group. All enrolled patients underwent neurodevelopmental assessment using the Bayley Scales of Infant and Toddler Development (BSTID) by a trained pediatrician, and 17 DHCA patients and 6 control patients completed the BSTID assessment. <b>Results:</b> Both groups showed no significant preoperative, operative, or postoperative differences. Adjusted multivariable analysis revealed that prematurity and age at assessment were significant changing predictors of each of the BSTID components (<i>p</i> < 0.001), except for the gross motor component, where only age at assessment was a significant adjusting predictor. Longer DHCA was associated with lower fine and gross motor BSTID components; however, the association was not statistically significant (<i>p</i> = 0.06). <b>Conclusions:</b> Long-duration DHCA without regional perfusion techniques may be associated with less optimal neurodevelopmental outcomes.https://www.mdpi.com/2036-7503/16/3/63Bayley Scalescongenital heart diseasesdeep hypothermic circulatory arrestneurodevelopmental
spellingShingle Abdullah H. Ghunaim
Basma Aljabri
Ahmed Dohain
Ghassan S. Althinayyan
Abdulaziz I. Aleissa
Ahmad T. Alshebly
Rayan A. Alyafi
Tareg M. Alhablany
Ahmed M. Nashar
Osman O. Al-Radi
Effect of the Duration of Deep Hypothermic Circulatory Arrest on the Neurodevelopmental Outcomes in Children Undergoing Cardiac Surgery
Pediatric Reports
Bayley Scales
congenital heart diseases
deep hypothermic circulatory arrest
neurodevelopmental
title Effect of the Duration of Deep Hypothermic Circulatory Arrest on the Neurodevelopmental Outcomes in Children Undergoing Cardiac Surgery
title_full Effect of the Duration of Deep Hypothermic Circulatory Arrest on the Neurodevelopmental Outcomes in Children Undergoing Cardiac Surgery
title_fullStr Effect of the Duration of Deep Hypothermic Circulatory Arrest on the Neurodevelopmental Outcomes in Children Undergoing Cardiac Surgery
title_full_unstemmed Effect of the Duration of Deep Hypothermic Circulatory Arrest on the Neurodevelopmental Outcomes in Children Undergoing Cardiac Surgery
title_short Effect of the Duration of Deep Hypothermic Circulatory Arrest on the Neurodevelopmental Outcomes in Children Undergoing Cardiac Surgery
title_sort effect of the duration of deep hypothermic circulatory arrest on the neurodevelopmental outcomes in children undergoing cardiac surgery
topic Bayley Scales
congenital heart diseases
deep hypothermic circulatory arrest
neurodevelopmental
url https://www.mdpi.com/2036-7503/16/3/63
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